Vitamin K in hand osteoarthritis: results from a randomised clinical trial

Objectives: Vitamin K has bone and cartilage effects, and previously shown to be associated with radiographic osteoarthritis. We evaluated vitamin K’s effect on hand osteoarthritis in a randomised controlled trial. Methods: This was an ancillary study to a randomised controlled trial assessing the effects of phylloquinone supplementation (vitamin K arm) versus placebo on bone loss and vascular calcification among older adults regardless of their vitamin K status. At the final 3-year study visit, we assessed the effects of vitamin K versus placebo on hand x-ray features of osteoarthritis using logistic regression and intention to treat, and also restricted analysis to the subgroup that had insufficient vitamin K concentrations at baseline. Results: This ancillary study had 378 participants (193 in vitamin K arm, 185 in placebo arm). There were no effects of randomisation to vitamin K for radiographic osteoarthritis outcomes. Those with insufficient vitamin K at baseline who attained sufficient concentrations at follow-up had trends towards 47% less joint space narrowing (p = 0.02). Conclusions: There was no overall effect of vitamin K on radiographic hand osteoarthritis. Subjects that were insufficient in vitamin K at baseline who attained sufficient concentrations at follow-up may have had a benefit in joint space narrowing. A clinical trial in those who are vitamin K insufficient may be warranted. Trial registration number: NCT00183001.

[1]  S. Booth,et al.  Effect of vitamin K supplementation on bone loss in elderly men and women. , 2008, The Journal of clinical endocrinology and metabolism.

[2]  R. D'Agostino,et al.  Vitamin K and vitamin D status: associations with inflammatory markers in the Framingham Offspring Study. , 2007, American journal of epidemiology.

[3]  H. Bischoff-Ferrari,et al.  Where do we stand on vitamin D? , 2007, Bone.

[4]  S. Lanham-New,et al.  Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. , 2006, Archives of internal medicine.

[5]  R. Terkeltaub,et al.  Low vitamin K status is associated with osteoarthritis in the hand and knee. , 2006, Arthritis and rheumatism.

[6]  M. Nevitt,et al.  The effect of estrogen plus progestin on knee symptoms and related disability in postmenopausal women: The Heart and Estrogen/Progestin Replacement Study, a randomized, double-blind, placebo-controlled trial. , 2001, Arthritis & Rheumatism.

[7]  P. Trumbo,et al.  Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. , 1998, Journal of the American Dietetic Association.

[8]  I. Shapiro,et al.  Matrix Gla Protein Is a Developmental Regulator of Chondrocyte Mineralization And, When Constitutively Expressed, Blocks Endochondral and Intramembranous Ossification in the Limb , 1999, The Journal of cell biology.

[9]  S. Booth,et al.  Dietary intake and adequacy of vitamin K. , 1998, The Journal of nutrition.

[10]  E. Liu,et al.  Human chondrocyte expression of growth-arrest-specific gene 6 and the tyrosine kinase receptor axl: potential role in autocrine signaling in cartilage. , 1997, Arthritis and rheumatism.

[11]  R. Behringer,et al.  Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA protein , 1997, Nature.

[12]  D. Felson,et al.  Relation of Dietary Intake and Serum Levels of Vitamin D to Progression of Osteoarthritis of the Knee among Participants in the Framingham Study , 1996, Annals of Internal Medicine.

[13]  P. Price Gla-containing proteins of bone. , 1989, Connective tissue research.

[14]  J. Hale,et al.  The identification of matrix Gla protein in cartilage. , 1988, The Journal of biological chemistry.

[15]  W. Jee,et al.  Excessive mineralization with growth plate closure in rats on chronic warfarin treatment. , 1982, Proceedings of the National Academy of Sciences of the United States of America.